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Peyronie’s Disease

Peyronie’s Disease is the presence of excess collagen formations (often called plaque) that affects the erectile bodies of the penis. The fibrotic lesions reduce penile tissue elasticity and can result in penile curvature, painful erections, constrictions (hour-glass deformity), loss of length or girth and erectile dysfunction. The prevalence of PD is reported as high as10% of the male population with a slightly increasing incidence with older age. Men who have undergone radical prostatectomy procedures for prostate cancer are at higher risk of developing Peyronie’s disease with reports as high as 20%.

A man’s initial response to palpating a hard nodule on the penis can cause a lot of anxiety and concern about a possible malignancy. Patients can easily be reassured by their physicians that Peyronie’s plaques are benign lesions and are only associated with sexual dysfunction.

Trauma to the penis is one of the most common causes of PD and can result during regular sexual intercourse when the penis bends or is struck severely, leading to scar tissue formation or plaques. These plaques can decrease normal tissue elasticity with the resultant changes in penile appearance. Genetics can predispose patients to PD. The presence of a family member with PD or other fibrotic tissue disorders such as Dupuytren’s contracture or plantar fibromatosis is associated with this condition. Medications belonging to certain drug classes have been reported to cause PD. Beta-blockers, anti-seizure medication (phenytoin) and certain supplements such as glucosamine / chondroitin or large doses of vitamin C are associated with PD.

Treatment options for patients with PD are various and depend on the degree of curvature and sexual disability in the individual patient. Many proven and unproven treatments exist. Your physician will determine which treatment option is appropriate for you. Treatment options found to be beneficial include:

Penile Plication – the penis is straightened by placing some plication sutures in the tunic of the corpora cavernosa

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Penile Grafting – the penis is straightened by excising the plaque and placing a graft material over the defect

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Penile Prosthesis and Modeling – the penis is straightened by placing a penile prosthesis and modelling the penis over the prosthesis. This is the treatment of choice for men with Peyronie’s Disease and concomitant erectile dysfunction (E.D.)

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Penile Prosthesis and Penile Plication/Grafting – in cases of severe Peyronie’s Disease associated with erectile dysfunction, a combination of penile implantation and penile plication/grafting is required to achieve a good functional and cosmetic result.

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Dr. Karpman will evaluate the degree of penile deformity and recommend treatment options. You are encouraged to bring in photographs taken from the best angle demonstrating the degree of the penile deformity to your appointment. These images will also be used as a baseline to assess the degree of improvement after therapy.